Abstract
During recent 20 years, enterovirus 71 (EV71) has emerged as a major concern among children, particularly in the Asia-Pacific region. To understand current EV71 serostatus, to find risk factors associated with EV71 infection and to establish future EV71 vaccine policy, we performed a seroepidemiology study in Taiwan in 2017. After informed consent was obtained, we enrolled preschool children, 6-15-year-old students, 16-50-year-old people. They received a questionnaire and a blood sample was collected to measure the EV71 neutralization antibody. Altogether, 920 subjects were enrolled with a male-to-female ratio of 1.03. The EV71 seropositive rate was 10% (8/82) in infants, 4% (6/153) in 1-year-old children, 8% (7/83) in 2-year-old children, 8% (13/156) in 3-5-year-old children, 31% (38/122) in 6-11-year-old primary school students, 45% (54/121) in 12-15-year-old high school students and 75% (152/203) in 16-50-year-old people. Risk factors associated with EV71 seropositivity in preschool children were female gender, having siblings, more siblings, and contact with herpangina or hand-foot-and-mouth disease. The risk factor with EV71 seropositivity in 16-50-year-old people was having children in their families in addition to older age (p<0.001). Compared with the rates in 1997, 1999 and 2007, the rates in children were significantly lower in 2017. EV71 seropositive rates were very low, at 4% to 10%, in preschool children and not high, at 31%, in primary school students. Preschool children are highly susceptible and need EV71 vaccine most.
Highlights
Enterovirus 71 (EV71) was first isolated in California, USA in 1969 [1]
Risk factors associated with enterovirus 71 (EV71) seropositivity in preschool children were female gender, having siblings, more siblings, and contact with herpangina or hand-foot-and-mouth disease
Large-scale outbreaks with frequent central nervous system (CNS)-complicated cases and deaths were found in Bulgaria, Hungary, Malaysia, Taiwan, Vietnam, Brunei, China and Cambodia [2,3,4,5,6,7,8]
Summary
Enterovirus 71 (EV71) was first isolated in California, USA in 1969 [1]. Since EV71 emerged in various regions throughout the world [2,3,4,5,6,7]. An EV71 epidemic swept Taiwan in 1998, which caused 405 severe cases and 78 deaths [8,9,10,11,12]. Multiple and real-time national enterovirus surveillance systems were established by the Taiwan Centers for Disease Control, including viral lab network; outpatient, inpatient, and emergency room visits for hand-foot-and-mouth-disease (HFMD) and/or herpangina (HA); and mandatory notification of enterovirus severe cases [13,14,15,16]. In addition to Taiwan, EV71 has emerged as a major concern among children in the Asia-Pacific region during recent 20 years [4,6,7]. During recent 20 years, enterovirus 71 (EV71) has emerged as a major concern among children, in the Asia-Pacific region. To understand current EV71 serostatus, to find risk factors associated with EV71 infection and to establish future EV71 vaccine policy, we performed a seroepidemiology study in Taiwan in 2017
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